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Medigap Plan M

Plan M covers many, but not all, of the out-of-pocket costs that can arise from Medicare coverage. 50% of the deductible for hospital services (Medicare Part A) is covered but the deductible for medical services (Medicare Part B) is not covered and must be paid by the enrollee. Additionally, excess charges above the Medicare-approved amount for a medical service is also not covered by Plan M.

The table below outlines which out-of-pocket costs are covered by Plan M and what out-of-pocket costs are not covered or partially covered.

Plan M Coverage

Medicare Part A Deductible

50% coverage

Medicare Part B Deductible

No coverage

Medicare Part B “Excess Charges”*

No coverage

Copayment or Co-Insurance Fee for Medicare Part B services

100% coverage

Part A Co-Insurance Fees & Hospital Costs for up to 365 days after Original Medicare Benefits are Exhausted

100% coverage

Cost of first 3 Pints of Blood

100% coverage

Copayment or Co-Insurance Fee for Medicare Part A Hospice Care

100% coverage

Co-Insurance Fees for Skilled Nursing Facility Care

100% coverage

Foreign Travel Medical Emergency Coverage (up to plan limits)

Yes

Annual Limit on Enrollee Out-of-Pocket Expenses?

Not Applicable

Plan M includes coverage (up to plan limits) for emergency healthcare received during foreign travel. Four out of ten Medigap plans do not include this benefit.

If you are interested in coverage for all the out-of-pocket costs listed in the above table, consider Plan F.

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